New Delhi, 7 May 2018: The Union Health Ministry’s recent move to criminalise non-reporting of tuberculosis (TB) cases to the government would provide a more realistic picture of the disease’s incidence and prevalence in the country and help track the ‘missing million’-- unregistered or undetected patients, say healthcare professionals and non-profit organisations active in anti-TB campaigns.

As per the new regulations, clinical establishments, including those in the private sector, will face punitive action if they fail to notify TB cases to the local public health authority – District Health Officer or Chief Medical Officer. Moreover, all pharmacies, chemists and druggists dispensing anti-TB medications must provide details of the patient, prescription and medical practitioner concerned to the nodal officer of the district failing which action will be taken against them.

In India, TB has been a notifiable disease since 2012. But the reporting was not mandatory and pharmacists or chemists were not included. Failure to report TB cases now attracts the provisions of sections 269 and 270 of the Indian Penal Code. Section 269 refers to a negligent act likely to spread infection of disease dangerous to life and Section 270 to a malignant act likely to spread infection of a dangerous disease. The offenders could face imprisonment up to two years.

While many healthcare professionals in the private sector slam the rules as too severe and unacceptable, the results are encouraging, say ministry sources. According to official figures, more than 28 lakh TB cases are reported in the country every year. As many as 14 lakh are listed by government hospitals. “Thanks to new measures to get TB cases notified, thousands of patients are detected and reported by the private sector every month. But many medical institutions, especially in northern states, remain reluctant to comply with the order. We have a long way to go to achieve the goal of TB elimination by 2025,” an official at the Central TB Division of the ministry told Pharmabiz.

India has the highest number of TB cases in the world, accounting for around one in four cases globally, according to the World Health Organisation. Even though there is lack of systematic data burden of TB in private sector, numerous studies have shown that more than 40 per cent of TB patients in the country are treated in the private sector.

“The estimation of number of patients treated using drug sales data puts this to be even 2–3 times higher than previously thought. Engaging private sector healthcare providers is the most important intervention to tackle this issue,” Qasim Sayyid of TB Alert India, a non-profit organisation that works with the government’s Revised National Tuberculosis Control Programme, pointed out.

TB is globally the top infectious disease killer and despite being the worst-affected country, India still has little idea of the true scale of the problem. “Many patients turn to unregulated private doctors who often do not report cases. Some of them are quacks. In fact, patients resort to about 6–9 care providers before finally reaching the directly observed treatment short-course centre,” Sayyid added. Pharmabiz